Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
Negotiating settlement of claims within designated authority.
Communicating claim activity and processing with the claimant and the client.
Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
Ability to review, understand and interpret contracts.
Requirements
4+ years of claims management experience or equivalent combination of education and experience required.
High School Diploma or GED required.
Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.
Home State License and ability to obtain New York licensing is a requirement for this role